To identify important prognostic factors and optimized treatment strategies through the analysis of the clinical and pathological characteristics of placental site trophoblastic tumor.108 patients with PSTT registered in two GTD centers or in six tertiary hospitals in China were analyzed retrospectively between the years 1998 and 2013. The computerized database of clinical and pathological reports was reviewed on this patient group. The data were subsequently analyzed retrospectively using SPSS software.Among 3581 patients with GTNs treated in GTD centers or in the tertiary hospitals between 1998 and 2013, 108 cases were histologically confirmed PSTT (3%). Only seven deaths and eleven relapse cases were observed. All seven of the deaths were disease related, due to chemotherapy-resistant or relapsed. 23 patients who received fertility preservation treatment did not experience poor outcome or high risk of relapse. In 71 patients with International Federation of Gynecology and Obstetrics (FIGO) stage I disease, the use of adjuvant chemotherapy following surgery (n=49) or not (n=22) made no significant difference in relapse rate (P=0.303) or survival (P=0.782). Univariate analysis revealed the interval between antecedent pregnancy and onset of PSTT, stage, prognosis score, and necrosis as significant predictors of poor survival but only stage remained significant on multivariate analysis.Patients with FIGO stage IV disease demonstrate the most critical risk indicator of PSTT in the current study. Preservation of fertility is considered in highly-selected patients with localized tumor; and surgery without chemotherapy is recommended as first line treatment for patients with stage I who are at low-risk.

Wang H.,Huazhong University of Science and Technology | Wang H.,Shandong University | Fan L.,Huazhong University of Science and Technology | Fan L.,Guangzhou Medical College | And 7 more authors.PLoS ONE | Year: 2012

Quantifiably and located measure the methylation rate of 21 cytosine-phosphate-guanosine (CpG) sites in the 3' region of L1 gene and long control region (LCR) gene of HPV16 DNA in asymptomatic patients, cervical intraepithelial neoplasia (CIN) patients, and cervical cancer patients. To analysis the relationship between HPV16 methylation and it's pathogenicity. Chosen 30 cases with HPV16 positive in each group. Firstly, extract DNA from the remaining cells of liquid-based cytology specimen and bisulfite treatment DNA, then amplify the 3' region of L1 gene and LCR gene, test the methylation rate of 21 CpG sites of HPV16 DNA in three groups. All of the 5 CpG sites in E6/E7 promoter (31, 37, 43, 52, 58) were hypomethylation in cervical cancer group (21.86%, 28.15%, 21.37%, 26.15%, 15.48%, respectively), hypermethylation in asymptomatic group, and middle-methylation in CIN group, in which there were significant difference among three groups (all P < 0.01). The CpG site in 7032, 7091, 7136 of the 3' region of L1 gene was also different methylated among three groups (all P < 0.01). Hypermethylation was found in cancer group (18.89%, 27.72%), hypomethylation was found in asymptomatic group (2.71%, 6.95%) in 7032 and 7091. In 7136, the highest methylation was detected in CIN (66.45%), the lowest in asymptomatic (34.85%), middle in cancer group (46.43%). The methylation status of CpG sites in the 3' region of L1 gene and E6/E7 promoter of HPV16 is significant different among three groups, which is likely to anticipate the pathogenesis of CIN and cervical cancer.

The aim of our study was to assess the levels of human epididymis protein 4 (HE4) with the common tumor marker carbohydrate antigen 125 (CA125) in the diagnosis and monitoring of therapy for primary fallopian tube carcinoma (PFTC).Serum HE4 and CA125 levels from 82 PFTC patients and 154 patients with benign pelvic masses as the control were measured by Roche electrochemiluminescent immunoassay. HE4 determinations for surgery response and recurrence monitoring were assessed in PFTC patients.Serum HE4 and CA125 concentrations were significantly higher in PFTC patients compared with those seen in patients with benign pelvic masses (P < 0.001). Compared with CA125, HE4 had higher specificity, but lower sensitivity whether at early or advanced stage, and the combination of HE4 + CA125 led to higher sensitivity and specificity. HE4 + CA125 performed significantly better than CA125 or HE4 alone in early stage patients. In early stage the sensitivity was 35.7% for HE4 and 64.3% for CA125, while sensitivity for the combination of HE4 and CA125 could reach 71.4%. Furthermore, the two markers were associated with the progression and histology of PFTC. Serum HE4 level was closely correlated with surgical therapy. PFTC patients displayed a greater decline in the level of HE4 compared with CA125 (76.4% vs 55.7%). Combined with CA125, HE4 elevation better predicted recurrence in PFTC patients.This study indicated that serum HE4 levels are closely associated with PFTC and the outcome of surgical therapy and recurrence in Chinese patients.